Fighting the Fire: HIV and Chronic Inflammation

Your immune system on overdrive, and that can wear down vital body systems over time.

-- Nelson Vergel, 55HIV treatment activistDiagnosed with AIDS in 1986

Nelson Vergel (Illustration: A.E. Kieren)

Both HIV and aging can cause chronic inflammation, when the body goes into overdrive to protect itself. That's not good -- and here's how to fight it.

You've heard of inflammation, right? It's when you bang your toe and the area around it gets all red and painful. Or when you've got the flu and the body, fighting off the infection, makes you feel all achey and awful. Inflammation may look and feel bad, but it signals that cells and proteins in your body are doing their job to fight off invaders. And that's a good thing.

Unless, that is, inflammation happens all the time. And research in the past 10 years has shown that people with HIV, even those who are on HIV meds with undetectable viral load, have high levels of chronic inflammation throughout their body. To put it simply, the immune system is working too hard, on overdrive, and that can wear down vital body systems over time, such as the heart and other organs, bone strength, and brain function, much faster than in HIV-negative folks. It can also promote certain cancers.

Add the fact that inflammation kicks in harder among older folks anyway, and those over 50 with HIV really have an inflammation issue on their hands. Unfortunately, pharma treatments fighting inflammation are still in the experimental phase. Until they're available, though, there are some things you can do -- in consultation with your doctor -- to reduce inflammation.

Take your HIV meds faithfully. The more active HIV you have in your system, the harder your immune system has to fight -- hence, the more inflammation. Taking your HIV meds correctly and consistently will almost always reduce HIV in your blood to an undetectable level, and that's good for fighting inflammation. But HIV can still be active in other body places, such as in your gut or your brain-spine area. That's why you should aim for the following inflammation-fighting steps.

Stop smoking! Last year, a Danish study found that HIV-positive people on effective HIV treatment lost more years of their life to smoking -- at least a dozen, to be exact -- than to HIV.

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Simply put, smoking plus HIV plus aging is an inflammation nightmare. Seek all the help you can -- doctors, friends, support groups, "the patch," oral medications, acupuncture, hypnosis, whatever -- to quit or reduce your smoking. Today, there are even "apps" for your phone to coach you toward quitting. And remember, never stop trying to quit!

Eat an anti-inflammation diet. Some foods increase inflammation while some foods fight against it. Nobody's perfect, and everyone loves a cheeseburger from time to time, but as much as you can, you should avoid red meat; overly fatty, salty, and sugary foods; and refined carbs such as white rice, white breads, pastries, pretzels, pastas, etc.

Eat as many as you can of fresh fruits and vegetables; lean proteins like chicken, salmon, and turkey; yogurt (great for stomach health!); whole grains (like those in wheat or multi-grain bread), brown rice, and beans; nuts of all sorts; natural foods of deep colors, such as sweet potatoes (instead of white), spinach, kale, beets, blueberries, and cranberries -- they're loaded with inflammation-fighters. So is dark chocolate, so eat a bit of that for dessert or a snack and skip the brownie. Instead of your morning bagel or muffin, try a bowl of fruit, yogurt, nuts, and ground flaxseed (an anti-inflammation superhero!), sweetened with a drizzle of honey.

Get off your butt. If you're already a running, swimming, or yoga nut, great. If your idea of exercise is the walk from the couch to the fridge to get more Ben & Jerry's, you should start moving vigorously at least 30 minutes a day. Try walking to or from work, lunch, or errands instead of driving or busing it. But before you attempt to become a triathlete, talk to your doctor and come up with a reasonable plan for you. Then go ahead and take the stairs instead of elevators or sign up with your friends for any fun, low-cost gym or exercise class you can find.

Talk to your doctor about anti-inflammatory supplements. Daily doses of baby aspirin, a quality multivitamin, turmeric, fish oils, and coenzyme Q10 have all proven to have strong anti-inflammatory power. So have cholesterol-lowering statin drugs. But talk to your doctor before starting any of these.

Tips From the Pros

Nelson Vergel, 55

The longtime activist, author of Testosterone: A Man's Guide and creator of nelsonvergel.com, shares his top advice for living long and strong with HIV.

Check your T levels. Make sure your doctor is monitoring your testosterone levels. Women, you too! Up to half of us HIV-positive folks over 50 have low testosterone, which can cause fatigue, depression, no sex drive, and reduced alertness.

Watch the sugar. Minimize processed sugars like in candy and pastries and go for fruit. That'll help you avoid or fight insulin resistance, which leads to diabetes. Avoid "white" foods like white rice, bread, and pasta. But yogurt's great! Go for deeply colored fruits and veggies. Avoid sodas, even diet ones. They're horrible for you. Drink water instead or green tea -- it's full of antioxidant power.

Don't skip breakfast. I do eggs with black beans and wild rice, or yogurt with nuts and berries. Breakfast sets you up metabolically for the rest of the day.

Get your vitamin D. It's important for bone density, and most of us don't get enough. Ask your doctor to recommend a quality supplement -- I use Jarrow. And get at least 20 minutes of sun a day.

Pap smears aren't just for women. All HIV-positive people need to get a yearly anal Pap smear, maybe even an anoscopy, because we have higher rates of HPV-related anal cancer. Many HIV doctors still don't know about this. Push your doctor to help you find someone who does this.

Care for your mind and soul. Don't get socially isolated. Reach out to local support groups. Find something you're passionate about. If you don't have a purpose, you may get depressed. Your full-time goal can't be only to stay healthy. Try volunteering -- it'll get you out of your own head. Don't wait for friends to reach out to you -- do it first.

Have sex! It's like a muscle: you have to use it or you're going to lose it.

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